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Acute Vision Loss Following Endoscopic Sinus Surgery.
Serena Byrd1, Adnan S Hussaini1, Jastin Antisdel1
1Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, Saint Louis, MO, USA.
Case Reports in Otolaryngology
|March 14, 2017
Summary
This case study highlights a rare instance of ophthalmic artery vasospasm after functional endoscopic sinus surgery (FESS). Sublingual nitroglycerin effectively treated this vision-threatening complication, offering a promising therapeutic option.
Area of Science:
- Ophthalmology
- Neurology
- Otolaryngology
Background:
- Functional endoscopic sinus surgery (FESS) is a common procedure for sinonasal diseases.
- Ophthalmic artery vasospasm is a rare but serious complication following FESS, potentially leading to irreversible vision loss.
- Patients with autoimmune conditions may have an increased risk of vasospasm due to heightened vasoreactivity.
Observation:
- A 41-year-old female with a history of uterine cancer, Celiac disease, and Raynaud's disease underwent FESS for migraines and nasal congestion.
- Postoperatively, the patient experienced acute unilateral vision loss, indicative of a potential ophthalmic complication.
Findings:
- The patient's vision loss was attributed to ophthalmic artery vasospasm, a rare post-FESS event.
- Sublingual nitroglycerin was administered and successfully resolved the ophthalmic artery vasospasm.
- This represents the first documented case of successful nitroglycerin treatment for post-FESS ophthalmic artery vasospasm.
Implications:
- Early diagnosis and prompt treatment are crucial to prevent permanent vision loss from ophthalmic artery vasospasm.
- Sublingual nitroglycerin is a viable and effective treatment for ophthalmic artery vasospasm due to its rapid action and ability to cross the blood-ocular barrier.
- This case suggests that patients with autoimmune diseases may require heightened vigilance for vasospastic events after FESS.
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